Sunday, January 25, 2009

Monday, January 12, 2009

Thank you guys

Saturday, January 10, 2009

my herniated disc

october 15th 2008 on a paddling trip with Thomas, Mary and John on the colorado river , i herniated my disc.
I had very painful condition that affected every aspect of my life.
After a long and painfull flight back home i had a nice talk with a dear friend who happened to be one of the best neurosugeon in the States.

tratements timeline:
Short period of rest
Ice pack
Hot pack
Non-steroidal anti-inflammatory drug (NSAIDs)
Oral steroid

Once I seen that image I knew why I was in so much pain. I was reading fail surgery's on Lumbar Discectomy, success rate's, the recovery time I would be expecting, the type of activity I would be able to do after surgery and anything else I could think of.

An epidural (cortisone) injection
........ and my mood has been a little off because of my lack of being able to get in my
kayaking activities. I missing it a lot !!!!

after two and a half month constant pain i asked for the surgery :(((

The surgical Procedure

What happens during the operation?
Patients are given a general anesthesia to put them to sleep during most spine surgeries. As you sleep, your breathing may be assisted with a ventilator. A ventilator is a device that controls and monitors the flow of air to the lungs.
Discectomy surgery is usually done with the patient kneeling face down in a special frame. The frame supports the patient so the abdomen is relaxed and free of pressure. This position lessens blood loss during surgery and gives the surgeon more room to work.

Laminotomy and Discectomy
Laminotomy and discectomy is the traditional method of removing the disc. Laminotomy is taking off part of the lamina bone (the back of the ring over the spinal canal). This allows greater room for the surgeon to take out part of the disc (discectomy).
An incision is made down the middle of the low back. After separating the tissues to expose the bones along the low back, the surgeon takes an X-ray to make sure that the procedure is being performed on the correct disc. A cutting tool is used to remove a small section of the lamina bone.

Next, the surgeon cuts a small opening in the ligamentum flavum, the long ligament between the lamina and the spinal cord. This exposes the nerves inside the spinal canal. The painful nerve root is gently moved aside so the injured disc can be examined. A hole is cut in the outside rim of the disc. Forceps are placed inside the hole in order to clean out disc material within the disc. Then the surgeon carefully looks inside and outside the disc space to locate and remove any additional disc fragments.

Finally, the nerve root is checked for tension. If it doesn't move freely, the surgeon may cut a larger opening in the neural foramen, the nerve passage between the vertebrae.

What happens after surgery?

Most patients leave the hospital the day after surgery. They are usually safe to drive within a week or two. Bending and lifting should be avoided for four to six weeks. People generally get back to light work in two to four weeks and can do heavier work and sports within two to three months. Workers whose jobs involve strenuous manual labor may be counseled to consider a less strenuous job.
Patients usually begin outpatient physical therapy two to three weeks after the date of surgery.

Friday, January 9, 2009

herniated disc

What is a herniated disc?

The spine is made up of a series of connected bones called "vertebrae." The disc is a combination of strong connective tissues which hold one vertebra to the next and acts as a cushion between the vertebrae. The disc is made of a tough outer layer called the "annulus fibrosus" and a gel-like center called the "nucleus pulposus." As you get older, the center of the disc may start to lose water content, making the disc less effective as a cushion. This may cause a displacement of the disc’s center (called a herniated or ruptured disc) through a crack in the outer layer. Most disc herniations occur in the bottom two discs of the lumbar spine, at and just below the waist.
A herniated lumbar disc can press on the nerves in the spine and may cause pain, numbness, tingling or weakness of the leg called "sciatica." Sciatica affects about 1-2% of all people, usually between the ages of 30 and 50.
A herniated lumbar disc may also cause back pain, although back pain alone (without leg pain) can have many causes other than a herniated disc

A herniated disc can affect how you're able to perform everyday tasks and can cause severe pain that influences almost everything you do. You and your doctor will make decisions about how to best treat your herniated disk (herniated disc), sometimes also called herniated disc, ruptured disc or slipped disc.
No single treatment choice is best for everyone. Your decisions will be based on a number of factors, including:
The nature of your condition
The degree to which it's affecting your lifestyle
The level of pain you're experiencing

What are the symptoms of a herniated disc?

When the spinal cord or spinal nerves become compressed, they don't work properly. This means that abnormal signals may get passed from the compressed nerves, or signals may not get passed at all. Common symptoms of a herniated disc include:

Electric Shock PainPressure on the nerve can cause abnormal sensations, commonly experienced as electric shock pains. When the compression occurs in the cervical (neck) region, the shocks go down your arms, when the compression is in the lumbar (low back) region, the shocks go down your legs.

Tingling & Numbness

Patients often have abnormal sensations such as tingling, numbness, or pins and needles. These symptoms may be experienced in the same region as painful electric shock sensations.

Muscle Weakness

Because of the nerve irritation, signals from the brain may be interrupted causing muscle weakness. Nerve irritation can also be tested by examining reflexes.

Bowel or Bladder Problems

These symptoms are important because it may be a sign of cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency, and your should see your doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals.

All of these symptoms are due to the irritation of the nerve from the herniated disc. By interfering with the pathway by which signals are sent from your brain out to your extremities and back to the brain, all of these symptoms can be caused by a herniated disc pressing against the nerves.
How is the diagnosis of a herniated disc made?

How is the diagnosis of a herniated disc made?

Most often, your physician can make the diagnosis of a herniated disc by physical examination. By testing sensation, muscle strength, and reflexes, your physician can often establish the diagnosis of a herniated disc.
An MRI is commonly used to aid in making the diagnosis of a herniated disc. It is very important that patients understand that the MRI is only useful when used in conjunction with examination findings. It is normal for a MRI of the lumbar spine to have abnormalities, especially as people age. Patients in their 20s may begin to have signs of disc wear, and this type of wear would be expected on MRIs of patients in their 40s and 50s. This is the reason that your physician may not be concerned with some MRI findings noted by the radiologist.
Making the diagnosis of a herniated disc, and coming up with a treatment plan depends on the symptoms experienced by the patient, the physical examination findings, and the x-ray and MRI results. Only once this information is put together can a reasonable treatment plan be considered.

Herniated Disc - Treatment Overview

The goals of treatment for a herniated disc are to:
Relieve pain, weakness, or numbness in the leg and lower back caused by pressure on a spinal
nerve root or the spinal cord.
Promote a return to normal work, recreation, and other activities.
Prevent reinjury to your back and reduce the risk of disability from back pain.

Because inflammation usually fades over time, about 50% of people with a herniated disc in the low back recover within 1 month. And within 6 months, most people recover.

1 Only 10% of people with herniated disc problems that cause noticeable symptoms eventually have surgery.2 Often a herniated disc heals on its own as the jellylike material (nucleus) inside the disc is broken down and absorbed by the body, a process called resorption. For this reason, nonsurgical treatment is typically recommended before surgery is considered.

Nonsurgical treatment
Nonsurgical treatment is intended to help you return to your daily activities and usually includes:
Education. Learn how to take care of your back, which may include training in pain and symptom control. Your doctor may recommend
physical therapy. A physical therapist can provide treatment with physical or mechanical means-such as through exercise or heat-and teach you exercises to do at home to strengthen the muscles that support your lower back.
Your doctor may recommend a short period of rest or reduced activity followed by a gradual increase in activity.
Pain relief. Some people can deal with pain without medicine if they know there is a good chance it will go away on its own. However, you can use medicine to control pain and
inflammation. Pain medicines include:
Nonprescription and prescription pain relievers, such as
acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs).
Muscle relaxants.
Exercise. Keep active and use exercises, as recommended by your doctor or physical therapist, to help you return to your usual level of activity.
Core stabilization exercises can help you strengthen the muscles of your trunk to protect your back.

Herniated Disc Surgery:

Removing the Herniation With a Decompression
If a course of conservative treatments is not effective for relieving pain from a herniated disc, lumbar decompression surgery may be considered as an option. A microdiscectomy (or microdecompression) is a type of lumbar decompression surgery that is minimally invasive, and often provides great relief. During the procedure, the herniated portion of the disc under the nerve root is removed, giving the nerve root room to heal.

Back pain

The spinal column is one of the most vital parts of the human body, supporting our trunks and making all of our movements possible. When the spine is injured and its function is impaired the consequences can be painful and even disabling. According to estimates, 80 percent of Americans will experience low back pain at least once in their lifetime. A small number of patients will develop chronic or degenerative spinal disorders that can be disabling.

How is the spine anatomically divided?

The spine is divided into 5 main sections: cervical, thoracic, lumbar, sacrum, and coccyx. The vertebrae in each section are numbered according to their location. This system provides health care professionals with a standard for communicating the location of patient injuries. The cervical region of the spine contains 7 vertebrae, the thoracic region contains 12 vertebrae, and the lumbar region contains 5 vertebrae. The sacrum is comprised of 5 fused vertebrae and the coccyx is comprised of 4 fused vertebrae. The structure of the vertebrae in each section of the spine is specific to the function those vertebrae perform.

Back pain is the eighth leading reason for a visit to a doctor. Americans spend $26 billion dollars a year on back pain treatment. You bend over to lift a heavy piece of furniture and as you lift it you feel a sharp pain in your back. You feel pain in your back and down your leg and people tell you it's sciatica. You have been working out after a long hiatus and the next morning your back hurts. You have been doing some very heavy lifting and now you are getting back pain with numbness that runs down the back of your leg into the foot.

What Are the Symptoms of Back Pain?

Most people have experienced back pain sometime in their life. The causes of back pain are numerous; some are self-inflicted due to a lifetime of bad habits. Other back pain causes include accidents, muscle strains, and sports injuries. Although the causes may be different, most often they share the same symptoms.

The symptoms for back pain are:

Persistent aching or stiffness anywhere along your spine, from the base of the neck to the hips.

Sharp, localized pain in the neck, upper back, or lower back -- especially after lifting heavy objects or engaging in other strenuous activity.

Chronic ache in the middle or lower back, especially after sitting or standing for extended periods.

Back pain that radiates from the low back to the buttock, down the back of the thigh, and into the calf and toes.

Inability to stand straight without having severe muscle spasms in the low back.

Call Your Doctor About Back Pain If:

You feel numbness, tingling, or loss of control in your arms or legs. This may signal damage to the spinal cord.

The pain in your back extends downward along the back of the leg. You may be suffering from sciatica.

The pain increases when you cough or bend forward at the waist. This can be the sign of a herniated disc.

The pain is accompanied by fever, burning during urination, or strong-smelling urine. You may have a bacterial urinary tract infection.

You have urine or fecal incontinence.

You have dull pain in one area of your spine when lying in or getting out of bed. If you are over 50 you may be suffering from osteoarthritis.

Because Mary said so.. or .. (my herniated disc-o-graphy )

Notes from Mary`s nootbook :

"October 15th, this is a landmark day. Tamas used the TEX river potty for the first time ever!
We saw the sign for Canyonland. I laid back in the canoe while John paddled.
We saw writing on the shore at one landing....that said 1800TTBOOKSHIP, so we wrote
"Death Ship" underneath it, just for kicks and giggles. While paddling this day, I told Eva and Tamas that boats with blue lettering are doomed (only to find out that our boat has the same)!"

Note from my nootbook :

....... October 16th 2008, i herniated my disc on the way to Lathrop Canyon .......

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